Definition

Acne occurs when the pores of the skin become clogged, inflamed, and sometimes infected. These clogged pores can result in blackheads, whiteheads, or pimples. Acne is common in teenagers, but can also occur in adults.

Causes

Acne starts in the skin's sebaceous glands. These glands secrete an oily substance called sebum. The sebum normally travels through a tiny hair follicle from the gland to the skin's surface. Sometimes the sebum becomes trapped, mixing with dead skin cells and bacteria. This causes clogged pores called comedones.

Blackheads are comedones that reach the skin's surface. Whiteheads are comedones that stay beneath the surface of the skin. Small red bumps, pimples, and cysts may also develop.

The main causes of acne include:

Changes in levels of male hormones called androgens

Increased sebum production

Changes inside the hair follicle

Bacteria

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.
Risk factors for acne include:

Age: between 12-24 years old

Race: Caucasian

Changes in hormone levels, such as during:

Puberty

Pregnancy

Before a menstrual period

Stress

Certain medicines (eg, androgens,
lithium
, and barbiturates)

Certain cosmetic products

Symptoms

Acne symptoms vary from person to person and can range from mild to severe. They include:

Excess oil in the skin

Blackheads

Whiteheads

Papules—small pink bumps that may be tender to the touch

Pimples—inflamed, pus-filled bumps that may be red at the base (also called pustules)

Nodules—large, painful, solid lumps that are lodged deep within the skin

Cysts—deep, inflamed, pus-filled lumps that can cause pain and scarring

Diagnosis

The doctor will examine the areas of your skin with the most sebaceous glands like the face, neck, back, chest, and shoulders. If your acne is severe, you may be referred to a dermatologist (skin specialist).

Treatment

Acne may need a combination of treatments. But, most acne does not require surgery. Some treatments may take several weeks to work. Your skin may actually appear to get worse before it gets better.

Medications

Over-the-counter topical medicines (eg, cleansers, creams, lotions, and gels)—to reduce the amount of oil and/or bacteria in the pores. These medicines may contain one or more of the following ingredients:

Benzoyl peroxide

Salicylic acid

Sulfur

Resorcinol

Prescription topical medicine—includes cleansers, creams, lotions, and gels to reduce the amount of oil and/or bacteria in the pores, for example:

Antibiotics, such as
clindamycin
(Cleocin T),
erythromycin

Tretinoin
(Retin-A, Avita)

Adapalene
(Differin)

Azelaic acid
(Azelex)

Tazarotene
(Tazorac)

Dapsone
(Aczone)

Oral antibiotics—to control the amount of bacteria in pores, including:

Doxycycline

Minocycline

Tetracycline

Erythromycin

Clindamycin

Amoxicillin

Cephalosporins

Sulfamethoxazole and trimethoprim

Oral medicines—to control androgen levels, including:

Birth control pills—Pills that have a combination of hormones (estrogen and progestin) may be the most effective in improving acne.

Spironolactone

Oral retinoids—to reduce the size and secretions of sebaceous glands. This medicine is only used for severe cases of cystic acne.

Isotretinoin
(Accutane)—must not be taken by women who are pregnant or who may become pregnant due to the risk of serious birth defects

Procedures

There are a number of procedures that can be used to treat acne, examples include:

Corticosteroids—the injection of corticosteroid directly into the cyst; mostly used for large, cystic acne lesions

Acne surgery—specialized extractors are used to open, drain, and remove contents of acne lesions

Use topical acne treatments only as directed. Using them more often could make your condition worse.

Recognize and limit emotional stress.

Wear sunscreen year-round. This is especially important if you are using medicine that can make your skin more sensitive to the sun.

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.